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. 2021 Apr 15;21(1):737.
doi: 10.1186/s12889-021-10765-1.

The epidemiological trends in the burden of lung cancer attributable to PM2.5 exposure in China

Xiaomei Wu  1 , Bo Zhu  2 , Jin Zhou  3 , Yifei Bi  4 , Shuang Xu  5 , Baosen Zhou  6
Affiliations

The epidemiological trends in the burden of lung cancer attributable to PM2.5 exposure in China

Xiaomei Wu et al. BMC Public Health. .

Abstract

Objective: PM2.5, which is a major contributor to air pollution, has large effects on lung cancer mortality. We want to analyse the long-term trends in lung cancer burden attributable to PM2.5 exposure and provide evidence that can be used for preventive measures and health resource planning.

Methods: Mortality data related to lung cancer were obtained from the Global Burden of Disease (GBD) 2019 project. A joinpoint regression analysis was used to assess the magnitude and direction of the trends in mortality from 1990 to 2019, and the age-period-cohort method was used to analyse the temporal trends in the mortality rate of lung cancer attributable to PM2.5 exposure by age, period, and cohort.

Results: From 1990 to 2019, the age-standardized mortality rate (ASMR) attributable to PM2.5 exposure trended slowly upwards, and the ASMR due to ambient PM2.5 exposure (APE) increased significantly, that due to household PM2.5 exposure (HPE) decreased. The longitudinal age curves show that the mortality rates due to PM2.5 exposure among younger individuals were low, and they significantly increased from their levels among those in the 45-49 age group to their levels among those in the over-85 age group. From 1990 to 2019, the period RRs due to APE increased, but those due to HPE decreased. Similar trends were observed in the cohort RRs. The overall net drift per year attributable to PM2.5 exposure was below 0. The local drift values increased with age and were above 0 for the over-80 age groups. The overall net drifts per year were above zero for APE and below zero for HPE. The corresponding results among males were higher than those among females.

Conclusions: In China, the type of air pollution responsible for lung cancer has changed from household air pollution to ambient air pollution. PM2.5 exposure is more harmful among males and older people. Ambient air pollution should be emphasized, and China should strengthen its implementation of effective public policies and other interventions.

Keywords: Age-period-cohort analysis; Ambient exposure; Household exposure; Lung cancer; PM2.5.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The temporal trends in the ASMR of lung cancer attributable to PM2.5 exposure from 1990 to 2019. a The mortality rate for both sexes due to PM2.5 exposure. b The mortality rate due to PM2.5 exposure by sex. c The mortality rate due to APE and HPE for both sexes. d The mortality rate due to APE and HPE by sex
Fig. 2
Fig. 2
The longitudinal age curves and period RRs of the mortality rate of lung cancer attributable to PM2.5 exposure from 1990 to 2019. a The longitudinal age curves for both sexes in PM2.5 exposure. b The longitudinal age curves by sex in PM2.5 exposure. c The longitudinal age curves for both sexes in APE and HPE. d The longitudinal age curves by sex in APE and HPE. e The period RRs for both sexes in PM2.5 exposure. f The period RRs by sex in PM2.5 exposure. g The period RRs for both sexes in APE and HPE. h The period RRs by sex in APE and HPE
Fig. 3
Fig. 3
The cohort RRs and local drifts of the mortality rate of lung cancer attributable to PM2.5 exposure from 1990 to 2019. a The cohort RRs for both sexes in PM2.5 exposure. b The cohort RRs by sex in PM2.5 exposure. c The cohort RRs for both sexes in APE and HPE. d The cohort RRs by sex in APE and HPE. e The local drifts for both sexes in PM2.5 exposure. f The local drifts by sex in PM2.5 exposure. g The local drifts for both sexes in APE and HPE. h The local drifts by sex in APE and HPE
See this image and copyright information in PMC

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